<!DOCTYPE html>
<html lang="en">
<head>
    <meta charset="UTF-8">
    <title>我要诉求-填写诉求信息</title>
</head>
<body>
<font color="red" size="4">在您诉求前，请您认真阅读：</font>
<u>诉求须知</u>
<br>
<font color="red" size="4">红色*为必填项</font>
<br>
<div style="background:blue;height:30px;width:150px;">
<p style="height:20px;color:white;text-align:center;">诉求基本信息</p>
</div>
<br>
<form name="form1" action="" method="get">
    <font color="red" size="1">*</font><font color="black" size="4">诉求分类:</font><br>
    <input type="radio" name="appeal" value="1" checked>投诉<input type="radio" name="appeal" value="2">咨询
    <input type="radio" name="appeal" value="3">建议<input type="radio" name="appeal" value="4">表扬
    <br>
    <font color="red" size="1">*</font><font color="black" size="4">问题发生所在城市</font><br>
    <select name="citys" id="city-select" style="height:40px;width:1000px">
        <option value="">请选择</option>
        <option value="1">沈阳</option>
        <option value="2">大连</option>
        <option value="3">鞍山</option>
        <option value="4">抚顺</option>
        <option value="5">本溪</option>
        <option value="6">丹东</option>
        <option value="7">营口</option>
    </select>
    <br>
    <font color="red" size="1">*</font><font color="black" size="4">问题发生所在区或县</font><br>
    <select name="city" id="cel-select" style="height:35px;width:1000px">
    <script type="text/javascript">
      var select = document.getElementById("city-select");
         select.onchange=function(){
             var selvalue = city-select.value;
             var val = document.getElementById("cel-select");
             switch(selvalue){

                 case "1" : val.innerHTML="<option>和平区</option ><option >沈河区</option>";break;
                 case "2" : val.innerHTML="<option>中山区</option ><option >西岗区</option>";break;
                 default : alert("erro");
             }
         };
    </script>
    </select>
    <br>
   <font color="red" size="1">*</font><font color="black" size="4">诉求主题</font><br>
    <input type="text" name="theme" style="height:35px;width:1000px" minlength="5"><br>
    <font color="red" size="1">*</font><font color="black" size="4">学校名称</font><br>
    <input type="text" name="schools" style="height:35px;width:1000px"><br>
    <font color="red" size="1">*</font><font color="black" size="4">年级</font><br>
    <input type="text" name="grade" style="height:35px;width:1000px" placeholder="如涉及多个年级，请在投诉内容里进一步表述"><br>
    <font color="red" size="1">*</font><font color="black" size="4">班级</font><br>
    <input type="text" name="classes" style="height:35px;width:1000px" placeholder="如涉及多个班级，请在投诉内容里进一步表述"><br>
    <font color="red" size="1">*</font><font color="black" size="4">教师姓名</font><br>
    <input type="text" name="teachers" style="height:35px;width:1000px" placeholder="如涉及多个老师，请在投诉内容里进一步表述"><br>
    <font color="red" size="1">*</font><font color="black" size="4">补课时间</font><br>
    <input type="text" name="times" style="height:35px;width:1000px"><br>
    <font color="red" size="1">*</font><font color="black" size="4">补课地址</font><br>
    <input type="text" name="adders" style="height:35px;width:1000px" placeholder="需提供详细地址，校外补课地址需精确到门牌号"><br>
    <font color="red" size="1">*</font><font color="black" size="4">收费金额（元）</font><br>
    <input type="text" name="money" style="height:35px;width:1000px"><br>
    <font color="red" size="1">*</font><font color="black" size="4">诉求详细内容（2000字以内）</font><br>
    <textarea name="content" style="height:150px;width:1000px" maxlength="2000" placeholder="请尽量填写详实"></textarea><br>
    <input type="file" name="pic" accept="image/*"><br>
    <div style="background:blue;height:30px;width:150px;">
    <p style="height:20px;color:white;text-align:center;">诉求人信息</p>
    </div>
    <br>
    <font color="red" size="1">*</font><font color="black" size="4">姓名</font><br>
    <input type="text" name="username" style="height:35px;width:1000px"><br>
    <font color="red" size="1">*</font><font color="black" size="4">职业</font><br>
    <select name="jobs" id="job" style="height:40px;width:1000px">
        <option value="">请选择</option>
        <option value="8">专业技术人员</option>
        <option value="9">企事业单位管理人员</option>
        <option value="10">商业/服务人员</option>
        <option value="11">教师</option>
        <option value="12">医药卫生工作人员</option>
        <option value="13">国家机关</option>
        <option value="14">农民</option>
    </select>
    <br>
    <font color="red" size="1">*</font><font color="black" size="4">手机号码</font><br>
    <input type="tel" name="phone" style="height:35px;width:1000px" placeholder="请输入真实的手机号码" maxlength="11">
    <br>
    <input type="button" value="获取短信码" onclick="sendyanzm()" style="font-size:15px;line-height:25px;">
    <input type="text" name="note" style="height:23px;width:80px"><br>
    <input type="submit" name="save" value="提交保存" onclick="formSubmit()"
           style="height:35px;width:1000px;background:blue;color:white">
</form>
</body>
</html>